Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, Baltimore, MD, USA.
Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA.
Alzheimers Dement. 2018 Sep;14(9):1148-1158. doi: 10.1016/j.jalz.2018.04.009. Epub 2018 Jun 28.
Infectious agents were recently implicated in Alzheimer's disease (AD) and etiology of other dementias, notably Helicobacter pylori.
We tested associations of H. pylori seropositivity with incident all-cause and AD dementia and with AD-related mortality among US adults in a retrospective cohort study. Data from the National Health and Nutrition Surveys III, phase 1 (1988-1991) and 1999-2000 linked with Medicare and National Death Index registries, were used (baseline age ≥45 y, follow-up to 2013, N = 5927).
A positive association between H. pylori seropositivity and AD mortality was found in men (hazard ratio = 4.33, 95% confidence interval: 1.51-12.41, P = .006), which was replicated for incident AD and all-cause dementia, with hazard ratio = 1.45 (95% confidence interval: 1.03-2.04, P = .035) and hazard ratio = 1.44 (95% confidence interval: 1.05-1.98, P = .022), respectively. These associations were also positive among higher socioeconomic status groups.
In sum, H. pylori seropositivity's direct association with AD mortality, all-cause dementia, and AD dementia was restricted to men and to higher socioeconomic status groups.
最近有研究表明，传染性病原体与阿尔茨海默病（AD）和其他类型痴呆症（尤其是幽门螺杆菌）的病因有关。
我们在一项回顾性队列研究中，检测了美国成年人中幽门螺杆菌血清阳性与全因和 AD 痴呆症发病以及 AD 相关死亡率的相关性。该研究的数据来自 1988-1991 年和 1999-2000 年的国家健康和营养调查 III 期（基线年龄≥45 岁，随访至 2013 年，N=5927），并与医疗保险和国家死亡指数登记处相关联。
我们发现幽门螺杆菌血清阳性与男性 AD 死亡率呈正相关（风险比=4.33，95%置信区间：1.51-12.41，P=0.006），该相关性在 AD 发病和全因痴呆症中也得到了复制，风险比分别为 1.45（95%置信区间：1.03-2.04，P=0.035）和 1.44（95%置信区间：1.05-1.98，P=0.022）。这些相关性在社会经济地位较高的人群中也呈阳性。
总之，幽门螺杆菌血清阳性与 AD 死亡率、全因痴呆症和 AD 痴呆症的直接相关性仅限于男性和社会经济地位较高的人群。
